Cortical cerebral microinfarcts on 7T MRI: Risk factors, neuroimaging correlates and cognitive functioning – The Medea-7T study

• Published in: Journal of cerebral blood flow and metabolism 2021-11, Vol.41 (11), p.3127-3138
• Main Authors: Zwartbol, Maarten HT, Rissanen, Ina, Ghaznawi, Rashid, de Bresser, Jeroen, Kuijf, Hugo J, Blom, Kim, Witkamp, Theo D, Koek, Huiberdina L, Biessels, Geert Jan, Hendrikse, Jeroen, Geerlings, Mirjam I
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain Infarction - diagnostic imaging; Brain Infarction - pathology; Cerebral Cortex - blood supply; Cerebral Cortex - pathology; Cerebrovascular Circulation - physiology; Cerebrovascular Disorders - complications; Cerebrovascular Disorders - diagnostic imaging; Cerebrovascular Disorders - pathology; Cognition - physiology; Cohort Studies; Dementia - diagnosis; Dementia - epidemiology; Dementia - pathology; Female; Heart Disease Risk Factors; Humans; Ischemic Attack, Transient - epidemiology; Magnetic Resonance Imaging - methods; Male; Memory - physiology; Middle Aged; Netherlands - epidemiology; Neuroimaging - methods; Neuropsychological Tests - statistics & numerical data; Original; Stroke - epidemiology
• ISSN: 0271-678X; 1559-7016; 1559-7016
• DOI: 10.1177/0271678X211025447

We determined the occurrence and association of cortical cerebral microinfarcts (CMIs) at 7 T MRI with risk factors, neuroimaging markers of small and large vessel disease, and cognitive functioning. Within the Medea-7T study, a diverse cohort of older persons with normal cognition, patients with vascular disease, and memory clinic patients, we included 386 participants (68 ± 9 years) with available 7 T and 1.5 T/3T brain MRI, and risk factor and neuropsychological data. CMIs were found in 10% of participants and were associated with older age (RR = 1.79 per +10 years, 95%CI 1.28–2.50), history of stroke or TIA (RR = 4.03, 95%CI 2.18–7.43), cortical infarcts (RR = 5.28, 95%CI 2.91–9.55), lacunes (RR = 5.66, 95%CI 2.85–11.27), cerebellar infarcts (RR = 2.73, 95%CI 1.27–5.84) and decreased cerebral blood flow (RR = 1.35 per −100 ml/min, 95%CI 1.00–1.83), after adjustment for age and sex. Furthermore, participants with >2 CMIs had 0.5 SD (95%CI 0.05–0.91) lower global cognitive performance, compared to participants without CMIs. Our results indicate that CMIs on 7 T MRI are observed in vascular and memory clinic patients with similar frequency, and are associated with older age, history of stroke or TIA, other brain infarcts, and poorer global cognitive functioning.